After Wisdom Tooth Removal

PLEASE READ AND FOLLOW THESE INSTRUCTIONS CAREFULLY. The after-effects of oral surgery vary per individual, so not all of these instructions may apply. Please free to call our office any time should you have any questions, or are experiencing any unusual symptoms following your treatment.

DAY OF SURGERY:

IMMEDIATELY AFTER SURGERY:

Patients who received a general anesthetic should return home from the office immediately upon discharge, and lie down with the head elevated until all the effects of the anesthetic have disappeared. Anesthetic effects vary by individual, and you may feel drowsy for a short period of time or for several hours. You should not operate any mechanical equipment or drive a motor vehicle for at least 12 hours or longer if you feel any residual effect from the anesthetic.

Do not drive or use appliances or equipment that could be dangerous, such as power tools, stove, burners, lawnmower, and garbage disposals.

Watch for dizziness. Walk slowly and take your time. Sudden changes of position can also cause nausea.

Do not make any important decisions. You may change your mind tomorrow.

Do not drink any alcoholic beverages. The drugs in your body may cause a dangerous reaction to alcohol.

Diet: If you feel nauseated or sick to your stomach, start with sips of water or ice chips, if these liquids do not make you sick to your stomach then try to drink clear liquids like broth, apple juice, Gatorade, tea, or jello. If still OK after 30 minutes try full liquids such as pudding, yogurt, milk shakes, and finally progressing to eating soft foods such as mashed potatoes, rice, overcooked pasta, scrambled eggs or fish.

Do not disturb the surgical area today. Bite down gently, but firmly on the gauze pack that we have initially placed over the surgical area, making sure that they remain in place. Do not change them for the first hour unless the bleeding is not being controlled. This is important to allow blood clot formation in the surgery site. The gauze may be changed when necessary and/or repositioned for comfort. DO NOT drink with a straw and DO NOT rinse, spit, or brush your teeth vigorously or probe the area with your tongue, any objects or your fingers. You may brush your teeth gently, carefully avoiding the surgical site.

DO NOT SMOKE for at least 48 hours, since it is detrimental to the healing process.

Beginning the day after surgery, start rinsing your mouth with a warm salt water rinse (1/2 tsp. salt with 1 cup water) every 2-3 hours. Continue this for one week, then rinse 3-4 times a day for the next 1-2 weeks. You may start normal tooth brushing the day after the surgery. It is imperative to keep your mouth clean, since an accumulation of plaque, food, or debris may promote infection.

BLEEDING:

Some bleeding is normal, and blood-tinged saliva may be present for 24-48 hours. This bleeding may be controlled by placing fresh gauze over the surgical area and biting down firmly for 30-60 minutes.

STEADY BLEEDING:

Bleeding should not be severe. If bleeding persists, this may due to the gauze pads being clenched between the teeth and absorbing the blood, rather than exerting pressure on the surgery site. Try repositioning the gauze. If bleeding persists or becomes heavy, substitute a moist tea bag (first soaked in hot water, squeezed dry and wrapped in a moist gauze) on the area for 20-30 minutes. If bleeding continues, please call our office.

SWELLING OR BRUISING:

Swelling is to be expected, and usually reaches its maximum in 2-3 days. To minimize swelling, cold packs or an ice bag wrapped in a towel should be applied to the face adjacent to the surgical area. This should be applied 20 minutes on one side and then switching to 20 minutes on the other side during the first 24 hours after surgery. After 24 hours, it is usually best to switch from using the cold pack to applying moist heat to the area (warm wash cloth or heating pad which can be moistened from the outside), until swelling has receded. Bruising may also occur, and may take one week to resolve. Tightness of the jaw muscles may cause difficulty in opening the mouth. This should disappear within 7 days. Keep lips moist with cream or Vaseline to prevent cracking or chapping.

DIET:

Eat any nourishing food that can be taken with comfort. It is advisable to confine the first day’s food intake to bland liquids or pureed or soft foods. Avoid foods like nuts, sunflower seeds or popcorn, which may get lodged in the socket areas. Over the next several days, you may progress to more solid foods. Proper nourishment aids in the healing process. If you are a diabetic, maintain your normal diet as much as possible and follow your physician’s instructions regarding your insulin schedule.

PAIN AND MEDICATIONS:

Unfortunately, most oral surgery is accompanied by some degree of discomfort. Take the pain medication preserved as directed. The local anesthetic administered with the general anesthetic during your surgery normally has a 3-hour duration (although you may have been given a longer acting local anesthetic which may last 6-7 hours), and it may be difficult to control the pain once the anesthetic wears off. We therefore, advise you to take the pain medication 2 hours after your surgery. If you do not achieve adequate pain relief, you may supplement each pill with 600mg Ibuprofen (Advil, Motrin) every 6 hours, this is usually 3 of the over the counter ibuprofen pills. Taking the pain medication with soft food and a large volume of water will lessen any side effects of nausea or stomach upset. If you were prescribed an antibiotic and are currently taking oral contraceptives, you must use an alternate method of birth control for the remainder of this cycle.

ACTIVITIES:

Rest today. No vigorous exercise since this may promote bleeding. It may take 1-2 weeks to return to strenuous activity or athletics depending upon recovery and activity (contact vs. non-contact sports).

ORTHODONTIC APPLIANCES:

If you wear orthodontic appliances, replace them immediately after surgery unless otherwise instructed. If these appliances are left out of the mouth for any length of time, it is often difficult or impossible to reinsert them.

OTHER POSSIBLE POST-SURGERY EFFECTS:

DRY SOCKETS:

The blood clot in the surgical site may be lost causing a dry socket (usually on the 3rd to 5th day). There will be a noticeable, distinct, and persistent pain in the jaw area, often radiating toward the ear and forward along the jaw which may cause other teeth to ache. Often this is accompanied by a foul odor. If you do not see steady improvement during the first few days after surgery or if severe pain persists, please call the office to report these symptoms.

SKIN DISCOLORATION:

This may be expected, and is usually limited to the neck or cheek area near the surgical site. This is caused by bleeding through the mucous membranes of the mouth, beneath the skin and appears as a bruise. If discoloration occurs, it often takes a week for this to completely disappear. Occasionally, the arm or hand near the site where the needle was placed to administer IV drugs may remain inflamed and tender. This is caused by chemical irritation in the vein. Ibuprofen and application of heat on the area will usually correct these symptoms.

BONY EDGES:

Small sharp bone fragments may work through the gums during the healing process. These are NOT roots. If annoying, return to our office for simple removal.

NUMBNESS:

Loss of sensation of the lip and chin may occur, usually following lower wisdom teeth removal. This is usually temporary and disappears within a few days or weeks. Occasionally, some numbness may persist for months, due to the close association of the roots of the teeth to the nerve that supplies sensation to these areas described.

It is our desire that your recovery be as smooth and pleasant as possible. If you have any questions about your progress or any symptoms you are experiencing, please call our office at Attleboro-Cumberland Oral Surgeons, Inc. Phone Number 508-699-0449. After office hours, you may call our 24-hour answering service and our doctor will contact you as soon as possible. Call 911 if you have a true medical emergency.

Attleboro-Cumberland Oral Surgeons, Inc. is proud to offer the highest level of care to our community. A combination of the latest treatments and technologies and a genuine passion for patient care allow us to provide our patients with optimal experiences and results in our office every day. Whether you are here for aesthetic or health reasons, we welcome you to our practice.